A nurse in a provider's office is teaching instructions to parents after reviewing medical records and completing an assessment of their toddler.

Which two of the following statements by a parent indicates understanding of the instructions? Select the two statements by a parent that indicate understanding of the instructions.

Rationale:

A. Notify the primary care provider immediately of this assessment finding: Immediate notification is not necessary unless there are additional acute concerns such as signs of illness or failure to thrive with rapid decline. Growth trends over time are more informative than a single measurement when evaluating potential growth issues.

B. Report the parents to the local authorities for potential child neglect: Being below the 5th percentile alone does not indicate neglect. Further assessment, including growth trends, dietary history, and developmental status, is required before considering reporting to authorities.

C. Compare the findings on the current growth chart to previous growth charts completed on the child: Evaluating growth trends over time is essential to determine whether the child’s growth pattern is consistent or showing deceleration. This helps identify potential chronic issues, nutritional deficiencies, or underlying medical conditions that require intervention.

D. Ask the parents to provide a detailed list of the child's usual diet in a 24-hour period: Dietary history can provide useful information, but it should be part of a broader assessment after reviewing growth trends. A single 24-hour recall may not accurately reflect the child’s typical nutritional intake and should not be the first step.

Rationale:

A. Somatic problems including frequent stomachaches and headaches: While some children with ASD may have gastrointestinal complaints or somatic symptoms, these are not core manifestations of the disorder. These issues may be secondary to stress, anxiety, or sensory sensitivities rather than defining features.

B. Destructiveness such as intentionally breaking toys, furniture, etc.: Intentional destructiveness is not a typical behavior associated with ASD. Children with ASD may have difficulty with frustration or transitions, but deliberately breaking objects is more characteristic of behavioral disorders rather than autism.

C. Repetitive behavior such as counting, arranging toys in a line, or hand flapping: Repetitive and stereotyped behaviors are hallmark features of ASD. These actions reflect the child’s need for predictability, sensory stimulation, or self-regulation and are commonly observed during early childhood.

D. Impulsive behavior such as throwing toys or running into the street without looking: Impulsivity is not a core symptom of ASD. While children with autism may have challenges with safety awareness or executive functioning, this behavior is more typical of attention-deficit/hyperactivity disorder (ADHD) than ASD.